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General NPI Number Information
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NPI Number | 1891893889
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Entity Type | Organization
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Legal Business Name | CHARLES P CAPITO
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 08/01/2011
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Provider Practice Location Address
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Address Line | 703 COLLIERS WAY
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City | WEIRTON
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State | WV
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Zip | 26062-5016
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Country | US
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Telephone | 304-723-3355
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Fax | 304-723-5638
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Provider Business Mailing Address
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Address Line | 703 COLLIERS WAY
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City | WEIRTON
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State | WV
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Zip | 26062-5016
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Country | US
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Telephone | 304-723-3355
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Fax | 304-723-5638
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHARLES PETER CAPITO
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Credential | MD
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Telephone | 304-723-3355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 12032
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License Number State | WV
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